Before you can start making use of the Billing Software in earnest, we'll need to establish some basic information and ground rules for your practice!
Navigate
In your toolbar, click on Settings, followed by Practice Settings
Practice Info
Enter your information here, and click [SAVE] when you're all done!
Note that the Billing Phone is what will appear on patient statements.
Clicking [Verify Now] on your address[es] will run what's been entered against the USPS database of addresses to ensure what's been input is valid.
If you're setting up your practice for the first time, you can ignore Online Payments for a later time. For further instruction to Activate Online Payments, click here!
Providers
Click [Add Provider]
Enter the provider NPI - this is almost always the Individual NPI.
Click [Add Provider] to automatically add the provider.
Your Provider should appear here in this list. They will also appear in the provider selection areas of your Superbills.
Continue adding as many providers as needed.
Under the ACTIONS tab, you will see three buttons - the blue EDIT, the yellow Provider Notes (chat bubble), and the red DEACTIVATE.
Edit will allow you to update any information specific to the provider.
Provider Notes will allow you to leave notes on the provider file. Please note that these notes cannot be deleted.
Deactivate will open a dialogue to confirm whether or not you'd like to set the provider to Inactive.
Service Locations
Click [Add Location]
If you have an NPI for this location, this is where you add it so it will appear in claims.
If you have added an NPI, you can click [Auto Populate] to fill out the name and address with what's on file.
Once the address has been added, click [Validate] to confirm it is proper.
Add the Location Type code used most often for this location - it can be changed on individual claims if needed.
Click [SAVE]
Claim Defaults
*Elation EHR + Billing - these defaults only apply to claims built directly in Elation Billing. To set a default Service Location in the EHR, click here to check out Visit Note Templates.*
You can designate default
Rendering Provider
Service Location
These settings will automatically be applied to a freshly built claim to save you time in the entry. You are still able to change these selections on a claim-by-claim basis.
Make sure to select [Save Defaults] when you've made your selections!
Insurance List
This shows a full list of payers that are present in our system.
Favorite Payers
Start by finding the insurances to whom you send claims, and select the ♡ to add it to your favorites. Doing so will allow you to condense your view of insurances here, as well as anywhere else you would make an insurance selection, by selecting [Favorites Only].
Note: when adding new patient insurance policies, Favorites Only is the default view.
Add A Payer
If you search for a payer that is not present, you can select the green [Add Payer] button. This will open a dialogue to add a payer to the system. You'll note the blue [CLAIMMD PAYER LIST] - this contains information on all payers with which our clearinghouse has a relationship, including Payer ID, as well as the electronic services available for these payers.
After adding the necessary info, we advise selecting [Verify Address].
Paper Claims
Payers with the PAPER payer ID will, when billed off, have their claims automatically printed and mailed for you at a cost of $1/claim.
If you intend to mail these paper claims yourself, see Step 2 of our article on the Claims Queue.
Button Guide
Blue "AKA": add/ edit payer nicknames (e.g. Blue Cross Blue Shield, AKA BCBS). These nicknames will be searchable when adding payers to claims, patients, etc.
Yellow: Edit Payer's address
Purple: Apply special payer rules for NPI/Tax ID
(The Default rules are to use the group NPI and practice Tax ID - use this if the payer requires a different NPI or Tax ID)
Red: add Payer Notes (e.g. phone #)
Enroll in EDI (Claims, ERA, Eligibility)
Select [Favorites Only]
If the payer says YES in the claims column, there is no need for further claims enrollment - you're all set to start submitting claims now!
If the payer says ENROLL in the CLAIMS, ERA, or ELIG, click the button to initiate enrollment. This will take you to a new page with our clearinghouse, which will contain instructions on enrolling for these services with these payers.
NOTE: Some enrollments require that you, after completing the enrollment process with the payer, select [Mark Completed]. This lets the clearinghouse know that you've enrolled!
Fee Schedule
You can adjust your default fee schedule (as % of your selected Medicare region) here anytime you like.
For custom fee schedules, you can adjust these fees code by code by creating a Superbill. You'll see the Superbill page when creating a claim.
Billing Rules
You can turn extra billing rules here. The billing rules currently apply to all roles except:
Practices
Admin
Biller
Billing Company
BillCo Admin
By default, rules for Eligibility, New Patients, Location, and Authorization will be on. These rules can be adjusted at any time.
Rules Explanations
Legacy Payment Workflows (Elation EHR + Billing only) | Re-enable the following
|
Biller & Admin Rule | You can turn this rule on if you want these billing rules to apply to ALL user roles. *NOTE* Do Not Use this if you are also using the New Patient Rule |
All Claims Rule | You can turn on this rule to route ALL NEW CLAIMS to Biller Review, rather than the Claims Queue. |
Eligibility Rule | This will catch claims where primary insurance eligibility has not been run as Active for the month, and drop them in the NEEDS ELIGIBILITY tag on the Worklist |
New Patients Rule | This will catch claims on patients with no prior submitted claims, and drop them in the NEW PATIENT tag on the Worklist so that the patient info can be reviewed for accuracy before submission. |
Location Rule | This will catch claims with E&M Codes that are specific to locations (e.g. a hospital visit isn't at the office) and drop them in the LOCATION CONFLICT tag on the Worklist. NOTE: This is limited to basic E&M codes like 99204, 99214, 99223 etc. |
Authorization Rule | This lets you add rules by either insurance company OR by code where authorization is required.
This will catch claims that fit these parameters and are missing authorizations and drop them in the NEEDS AUTH tag on the Worklist |
Track Claims with 'No Response' | Claims that haven't received a response from the payer in [x] days will be tagged as "No Response" - you can adjust how many days must pass before claims get tagged
Note: this tool runs in the evening, so claims will not appear on the worklist until the morning after the Rule is activated |
Users
This page is for adding Practice Users. These are staff members that work in the practice. These users will have access only to this practice.
NOTE: Billing Companies use this area to create Practice Users and use the Account Users option under the Settings drop-down menu to add Billing Company users.
Users can be added at any time.
Tags
This is where you can Edit or Delete custom tags for Patients and Claims.
To create a new tag, press the [+] next to the type (Patient or Claim) of tag you'd like to create.
Use the pop-up to create your tag, entering the desired text and selecting what color you'd like it to be.
Above where you can type your text, you'll see a live update of what your tag will look like across the Billing Software.
Click Here to check out our article on Using the Worklist. To learn how to create custom tags directly on a claim, check out Step 3 of the article!